09 Oct 2011
By: TAN HUI YEE
Mr Wang Qingli winces slightly during the handshake, then quickly smiles apologetically. He does not mean to be rude but that handshake hurts.
The 31-year-old construction worker had part of his right index finger amputated after an accident in July. It now resembles a thumb. What bothers him, though, is less the loss of the digit than his experience at the private hospital where he was taken for treatment.
The doctor there gave him just two days of medical leave after the amputation, and Mr Wang was deemed fit for “light duty” for the next 20 days.
The Chinese national seethes at the memory of it. “There’s no such thing as ‘light duty’ in construction work,” he says in Mandarin. “Either you work, or you don’t work.”
He has stopped work since his accident but many other workers in similar situations have been turning up at the offices of migrant-worker help groups and law firms dealing with compensation claims.
Their injuries vary, but their stories sound the same: Having been injured, they were taken to private clinics or hospitals for treatment.
They got few, if any, days of medical leave. The certificates would say they were fit for light duty after their wounds had been stitched up or bandaged.
Hoh Law Corporation, which about three years ago had not encountered such cases, now sees at least 70 each month.
The proportion of such workers among its clients seeking compensation for injuries is also increasing.
Gabriel Law Corporation estimates that at least 40 per cent of the injured workers it is helping to seek compensation have had similar experiences – “a big jump” from about 10 per cent a year ago.
And doctors at Singapore General Hospital (SGH) note that “many injured workers turn up to seek a second opinion”.
Such instances are a concern for migrant-worker advocacy groups. One of them, the Humanitarian Organisation for Migration Economics (Home), filed eight complaints over the last two weeks against six private doctors.
In letters to the Singapore Medical Council (SMC), Home executive director Jolovan Wham asked if the doctors were giving these workers fewer days of medical leave than appropriate so that the workers’ employers need not report the accidents to the Ministry of Manpower.
The law requires companies to pay workers medical-leave wages, so under-reporting of such leave saves them money.
Also, the affected companies must submit accident reports for cases that involve medical leave of more than three consecutive days due to injury. For the affected workers, without such reports, it may be difficult for them to claim compensation.
A bad safety record, meanwhile, could result in an employer being penalised by the Ministry of Manpower.
Given such high stakes, and with about 10,000 workplace injuries every year, both employers and workers have tried to game the system in the past.
Just as employers have been known to under-report accidents, some workers have been known to deliberately injure themselves or to exaggerate the extent of their injury to claim more compensation.
Mr Wham made the complaints to the SMC on behalf of eight workers, most of whom had fractures on their arms or fingers and were given, at most, two days’ sick leave. Of these eight workers, seven subsequently turned to public hospitals for a second opinion and were given more days to recuperate.
Two of the men agreed to speak to The Sunday Times. One of them is Mr Wang.
The father of three from Jiangsu province in eastern China was working on an industrial building in Tuas on July 25 when his finger was crushed. He was taken to Raffles Hospital where he was treated by orthopaedic surgeon Lim Yeow Wai.
There, Mr Wang alleges, a staff member told him: “If your employer doesn’t agree, we can’t give you medical leave.”
When contacted, Raffles Hospital refuted the claim. Its spokesman said: “Dr Lim feels that the medical leave followed by light duties was appropriate for the patient’s condition.”
He said it was not influenced by the construction company, adding: “Long medical leave is issued by our doctors where it is warranted, especially for major injuries... We review patients frequently to ensure that the appropriate medical leave is given.”
The spokesman clarified that “light duty” refers to sedentary or desk work.
Tiong Seng Contractors, which oversees Mr Wang’s worksite, said light duty could mean working as an assistant storekeeper or as a drain cleaner.
It stressed that an accident report had already been filed for Mr Wang’s case. Its director, Mr Andrew Khng, said injured workers are sent to Raffles Hospital simply because they get faster treatment there.
“Queues at the accident and emergency departments (at public hospitals) are tremendously long.”
Besides, he said, it does not cost more to treat workers at its appointed private hospital as public hospital subsidies were withdrawn from foreigners in 2008.
Mr Khng said Tiong Seng does not try to influence the doctors treating its workers. “I don’t think we’re in a position to.”
Mr Wang did not seek a second opinion after the initial diagnosis by his company-appointed doctor. But he stopped work completely because of the pain and lodged a compensation claim.
The Sunday Times asked Khoo Teck Puat Hospital, which treats an average of 350 patients daily at its acute and emergency care centre, how it would assess the case of a partially severed finger.
Dr Shaun Goh, an associate consultant there, said that in general, one week of medical leave is given after the appropriate treatment. Any extension of medical leave is given upon review of the wound.
Another case involving an injured construction worker has pit the medical judgment of a private doctor against that of doctors in a public hospital.
Mr Jiang Wenbin, a 36-year-old Chinese national, fractured his left thumb in July and was taken to see orthopaedic surgeon Kevin Yip, who runs a clinic at Gleneagles Medical Centre.
Dr Yip stitched and cleaned the wound before giving Mr Jiang two days’ medical leave, followed by five days of light duty.
Mr Jiang said he was not given a copy of his medical certificate even though he asked for it.
Not true, said Dr Yip.
The doctor said Mr Jiang had not asked for a copy. The clinic, he explained, usually submits a copy of the certificate to the worker’s employer, and to the worker himself upon request.
In any case, one day after being treated by Dr Yip, Mr Jiang was still concerned about his situation, so he walked to Singapore General Hospital from his quarters at Marina Bay. The SGH doctors gave him seven days of leave on his first visit.
On follow-up visits, he was given hospitalisation leave in separate tranches, amounting to 78 days in total.
Dr Yip, in his e-mail response to The Sunday Times, said Mr Jiang did not return to his clinic for a review after his light duty period had ended, despite a phone-call reminder.
“If he had returned and the wound was not healing well, medical leave would have been extended if necessary.”
The private doctor felt there was no need for prolonged medical leave in the first instance as “the injury only involved the tip of the left thumb”.
Like Raffles Hospital, he too stressed that “there is no agreement between myself and the construction company regarding limitation of medical leave for their employees”.
Mr Jiang’s employer, Ansen Construction, said it had filed an accident report. It also said the worker had messed up its record-keeping. Ansen deputy general manager Lin Wen said: “He switched doctors in an irresponsible manner.”
Mr Lin said the company merely explains to Dr Yip the range of jobs – including what amounts to light duty – available at a worksite. But it does not try to sway the doctor’s decision, he stressed.
He conceded that SGH’s doctors were entitled to their medical opinion but added that SGH “seems to have no control” over the way it grants medical leave.
SGH took issue with this comment.
Dr Andrew Chin, who heads its department of hand surgery, said its doctors do recommend light duties when “early return to work may help patients in their overall recovery”.
“However, patients frequently return to the clinic, claiming that they were not given light duties or were expected to perform their usual duties,” he said.
Some companies, he noted, help build confidence by having a representative accompany the injured worker to discuss the situation with the doctor or provide written details of the duties that will be assigned to the patient.
In any case, “our patients’ safety and well-being are a priority to us”, said Dr Chin. He added: “We need to ensure that patients recover in a safe environment without further stress to their injuries.
“Medical leave may be issued for as long as patients are unable to perform the duties expected of them.”
The Singapore Medical Council has declined to comment on the complaints made by the workers against the doctors.
Mr Wang, the worker who lost one-third of his finger, has since been awarded $19,800 compensation for his injury. “I want to go home, rest a while, and then think of what to do,” he says quietly.
His wound may have healed, but his stump still hurts, especially when he tries to wield a hammer like before.
Although he may not return to Singapore, he wonders what lies in store for his co-workers who remain.
“As it is, we do work that Singaporeans don’t want. I hope what happened to me doesn’t happen to others.”
Email: tanhy@sph.com.sg
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